Validity of Uniform Chart of Accounts as a Measure of Resource Consumption at the Patient Level

摘要

With the Medicare Diagnosis Related Groups (DRGs) prospective payment system that started 1 October 1983, came a new era of reimbursing medical institutions and providers for care rendered to patients. This is futuristic and the concern of today's military health care manager is with the Uniform Chart of Accounts (UCA). The specific sequential objectives of this research effort included the identification of historic patient discharge costs for various DRGs within WHMC(Wilford Hall USAF Medical Center) to determine if UCA costs discriminate UCA inpatient services with different case-mix complexities. Next, a comparison between selected DRG relative cost weights and corresponding HCFA DRG relative cost weights was accomplished to determine if there was correlation between the two weights. The next objective was to determine to what UCA DRG costs predicts known HCFA DRG costs from a 1981 study. In accomplishing this study, an objective was to conduct an extensive literature review. Finally, the major objective of this study, and one which the preceeding objectives support, was to recommend further utilization or change of the UCA comparison procedures. The research question was evaluated using a series of hypotheses tests involving the difference between means, a correlation analysis, and a regression analysis.